EP0002495A1 - Composition à utiliser en thérapie cytostatique - Google Patents

Composition à utiliser en thérapie cytostatique Download PDF

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Publication number
EP0002495A1
EP0002495A1 EP78101583A EP78101583A EP0002495A1 EP 0002495 A1 EP0002495 A1 EP 0002495A1 EP 78101583 A EP78101583 A EP 78101583A EP 78101583 A EP78101583 A EP 78101583A EP 0002495 A1 EP0002495 A1 EP 0002495A1
Authority
EP
European Patent Office
Prior art keywords
chloroethyl
oxo
acid
cytostatic
salt
Prior art date
Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
Granted
Application number
EP78101583A
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German (de)
English (en)
Other versions
EP0002495B1 (fr
Inventor
Norbert Prof. Dr. Brock
Current Assignee (The listed assignees may be inaccurate. Google has not performed a legal analysis and makes no representation or warranty as to the accuracy of the list.)
Asta Medica GmbH
Original Assignee
Asta Werke AG Chemische Fabrik
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Priority claimed from DE2756018A external-priority patent/DE2756018C2/de
Application filed by Asta Werke AG Chemische Fabrik filed Critical Asta Werke AG Chemische Fabrik
Publication of EP0002495A1 publication Critical patent/EP0002495A1/fr
Application granted granted Critical
Publication of EP0002495B1 publication Critical patent/EP0002495B1/fr
Expired legal-status Critical Current

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Classifications

    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61KPREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K31/00Medicinal preparations containing organic active ingredients
    • A61K31/66Phosphorus compounds
    • A61K31/675Phosphorus compounds having nitrogen as a ring hetero atom, e.g. pyridoxal phosphate
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61KPREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K31/00Medicinal preparations containing organic active ingredients
    • A61K31/185Acids; Anhydrides, halides or salts thereof, e.g. sulfur acids, imidic, hydrazonic or hydroximic acids
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61PSPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
    • A61P35/00Antineoplastic agents
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61PSPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
    • A61P39/00General protective or antinoxious agents
    • A61P39/02Antidotes

Definitions

  • alkylantia cytostatics such as melphalan, cyclophosphamide, trofosfamide, ifosfamide, sufosfamide, chlorambucil, busulfan, triethylene thiophosphamide or triaziquone and in particular the 2-oxo-1,3,2-oxazaphosphorinanes cyclophosphamide, trofosfamide, ifosfanide and severe side effects occur as undesirable effects Irritation of the kidney, urinary tract and / or the bladder of the treated patient. It is known that these side effects occur particularly easily after the first damage. This undesirable side effect can be so severe that the therapy of the patient suffering from cancer is temporarily interrupted or even completely impossible.
  • cytostatics are administered when they are first applied in a single dose that is high in relation to their toxicity in order to achieve the highest possible initial concentration of the cytostatic in the tumor tissue. Thereafter, the cytostatics are often administered in lower doses over long periods of time. It is known that the undesirable side effect described is caused by metabolites of cytostatics formed in the patient's body.
  • the side effect occurs with alkylants known for some time, such as those known under the well-known name Endoxan® or cyclophosphamide 2- (N, N-bis- (2-chloroethyl) -amino) -2-oxo-1,3,2-oxazaphosphorinane and under the 2- (N, N-bis- known as IxotenQ9 or trofosfamide (2-chloroethyl) amino) -3- (2-chloroethyl) -2-oxo-1,3,2-oxazaphosphorinane frequently.
  • This side effect is even more important if you administer highly cytostatic and at the same time less toxic alkylating agent cytostatics such as ifosfamide.
  • the therapeutic uses which are due to the low toxicity, are significantly limited by this side effect. It has even been observed that bladder cancer developed due to such irritation of the bladder.
  • This so-called hydration is generally associated with an alkalinization of the urine, for example with the hexakalium hexasodium pentacitrate hydrate complex commercially available under the name Uralyt® -U, and in particular with the introduction of solutions of compounds containing mercapto groups into the bladder through catheters.
  • Such compounds containing mercapto groups were thought to react with the alkylating groups and so on deactivated.
  • N-acetylcysteine and cysteine were used as such a compound.
  • success has been limited, particularly when using cytostatics in very high doses.
  • bladder irrigation is difficult for the patient and practically hardly feasible when the cytostatics are administered over long periods of time. After all, higher areas of the urinary tract are not accessible at all.
  • the salt of mercaptoalkanesulfonic acid can be administered in the same or in a different usual application form than the cytostatic agent.
  • the cytostatic can be administered intravenously, while the salt of mercaptoalkanesulfonic acid can be administered orally or intraperitoneally.
  • the salt of mercaptoalkanesulfonic acid is preferably administered simultaneously with the cytostatic agent. This applies in particular to the high initial dose customary in shock therapy. Both compounds are then preferably administered in a single application unit.
  • the present invention thus relates to the use of pharmacologically acceptable salts of a mercaptoalkanesulfonic acid of the general formula wherein alk is a straight-chain or branched alkylene radical having 2 to 6 carbon atoms, in cytostatic therapy with alkylating agents, be it in the form of combination preparations containing the salt and the alkylan, or in the form of separate preparations for the simultaneous or time-graded combined administration of certain preparations .
  • the alkali salts are very particularly suitable here, especially the sodium salt of 2-mercaptoethanesulfonic acid.
  • the administration of amounts as small as 20% of the dose of the cytostatic is sufficient. This is especially true at lower doses of the cytostatic. At higher doses of the cytostatic, the harmful side effect can be prevented with 30% of the amount of the cytostatic. Since the side effect is particularly important when administering the cytostatics in high doses, the lower limit of 30% of the amount of the cytostatic is preferably used. In view of the known, very low toxicity of the pharmacologically acceptable salts of mercaptoalkanesulfonic acids, the upper limit of the quantity range for the salt of mercaptoalkanesulfonic acid is of minor importance.
  • cytostatic activity of the alkylating agents is not impaired. In animal experiments, this was found for ifosfamide even with a 100-fold greater dose of the sodium salt of beta-mercaptoethanesulfonic acid than the dose of the cytostatic. Since a practical elimination of the side effect is generally achieved even with high doses of cytostatics with equal amounts of the salt of mercaptoalkanesulfonic acid, it is preferred to add the salt of mercaptoalkanesulfonic acid in an amount corresponding to 30 to 100% of the amount when the mercaptoalkanesulfonic acid is administered prior to administration Apply cytostatic to be administered or the administered cytostatic.
  • salts of mercaptoalkanesulfonic acids can be used in conjunction with all alkylating agents and thereby prevent the described harmful and particularly undesirable side effect, they have particular their importance in connection with the 2-0xo-1,3,2-oxazaphosphorinane cyclophosphamide, ifosfamide, trofosfamide and sufosfamide used to a large extent to combat a wide variety of cancers.
  • mercaptoalkanesulfonic acids used according to the invention are known compounds (cf. US Pat. No. 2,694,732). They have also been used for therapeutic purposes, specifically as mucolytically active compounds in preparations other than those required for the use according to the invention (cf. DE-OS 1 620 629). However, these or similar compounds have so far not been used to prevent the side effect of the alkylating agent cytostatics described.
  • a 56-year-old patient suffering from kidney hypernephroma is treated according to the rules of therapy, with radiation and ifosfamide [2- (N-2-chloroethylamino) -3- (2-chloroethyl) -2-oxo- 1,3,2-oxazaphosphorinan] (5 x 60 mg / kg intravenously for 5 consecutive days).
  • the patient is hydrated by adding 4 liters of water throughout the day and alkalized by administration of hexapotassium hexasodium pentacitrate-hydrate complex.
  • the patient reacts with strong macrohematuria, which forces the therapy to be stopped immediately.
  • the therapy is repeated, but this time, with each dose of 60 mg / kg ifosfamide, 35 mg / kg of the sodium salt of 2-mercaptoethanesulfonic acid is administered intravenously.
  • the patient was checked daily for micro and macro hematuria or protein excretion in the urine. There were no signs of hematuria or protein excretion.
  • the sodium salt of 2-mercapto-ethanesulfonic acid was administered orally 1/2 hour before application of the alkylane.
  • a dosage of 30 mg / kg to 60 mg / kg of the sodium salt of 2-mercaptoethanesulfonic acid at a dose of 60 mg / kg of the alkylane no harmful side effects were demonstrated.
  • the effectiveness of the salts of mercaptoalkanesulfonic acids of the general formula described above was investigated on the model of ifosfamide cystitis in the rat.
  • a single intravenous dose of 68.1 mg / kg ifosfamide or cyclophosphamide can cause cystitis in the rat.
  • a trypan blue solution is administered intravenously to the animals 24 hours after the cytostatic agent has been administered, and the animals are sacrificed under ether anesthesia after a further 30 minutes. With the help of the vital dye trypan blue, foci of inflammation can be displayed macroscopically.
  • the bladders of the test animals are deep blue in color, swollen and some have bleeding.
  • the investigated compounds used according to the invention were administered simultaneously with the cytostatic agent or up to 15 min before application of the cytostatic agent i.v. administered.
  • the toxicity of the investigated compounds was approximately the same and very low (DL 50> 2000 mg / kg).

Landscapes

  • Health & Medical Sciences (AREA)
  • Public Health (AREA)
  • Veterinary Medicine (AREA)
  • Animal Behavior & Ethology (AREA)
  • General Health & Medical Sciences (AREA)
  • Medicinal Chemistry (AREA)
  • Chemical & Material Sciences (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Pharmacology & Pharmacy (AREA)
  • Epidemiology (AREA)
  • Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
  • General Chemical & Material Sciences (AREA)
  • Chemical Kinetics & Catalysis (AREA)
  • Organic Chemistry (AREA)
  • Toxicology (AREA)
  • Acyclic And Carbocyclic Compounds In Medicinal Compositions (AREA)
  • Pharmaceuticals Containing Other Organic And Inorganic Compounds (AREA)
  • Medicines Containing Antibodies Or Antigens For Use As Internal Diagnostic Agents (AREA)
  • Medicinal Preparation (AREA)
EP78101583A 1977-12-14 1978-12-06 Composition à utiliser en thérapie cytostatique Expired EP0002495B1 (fr)

Applications Claiming Priority (4)

Application Number Priority Date Filing Date Title
DE2756018 1977-12-14
DE2756018A DE2756018C2 (de) 1977-12-14 1977-12-14 Verwendung von Salzen von Mercaptoalkansulfonsäuren
DE2827625 1978-06-23
DE2827625 1978-06-23

Publications (2)

Publication Number Publication Date
EP0002495A1 true EP0002495A1 (fr) 1979-06-27
EP0002495B1 EP0002495B1 (fr) 1984-02-15

Family

ID=25773277

Family Applications (1)

Application Number Title Priority Date Filing Date
EP78101583A Expired EP0002495B1 (fr) 1977-12-14 1978-12-06 Composition à utiliser en thérapie cytostatique

Country Status (6)

Country Link
US (1) US4220660A (fr)
EP (1) EP0002495B1 (fr)
JP (1) JPS54101432A (fr)
DK (1) DK154608C (fr)
FI (1) FI783756A (fr)
NO (1) NO784192L (fr)

Cited By (4)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
EP0198542A1 (fr) * 1985-04-15 1986-10-22 Schering Spa Compositions pharmaceutiques à base d'acide mercaptoéthanesulfonique, dérivés salins organiques d'acide mercaptoéthanesulfonique et leur procédé de fabrication
US4716242A (en) * 1984-03-01 1987-12-29 Asta-Werke Aktiengesellschaft Chemische Fabrik Salts of oxazaphosphorine derivatives
EP0334083A1 (fr) * 1988-03-19 1989-09-27 ASTA Pharma Aktiengesellschaft Composition lyophilisée à base de ifosfamide-mesna et procédé pour sa préparation
US5663145A (en) * 1993-12-09 1997-09-02 Asta Medica Aktiengesellschaft Products for administering an initial high dose of Cetrorelix and producing a combination package for use when treating diseases

Families Citing this family (13)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US5244920A (en) * 1985-04-15 1993-09-14 Schering Spa Pharmaceutical compositions having therapeutical activity based on mercaptoethansulphonic arginine salt
JPH01174407U (fr) * 1988-05-26 1989-12-12
US6197831B1 (en) * 1999-02-09 2001-03-06 Bionumerik Pharmaceuticals, Inc. Method of treating septic shock
US6077838A (en) * 1999-06-08 2000-06-20 Bionumerik Pharmaceuticals, Inc. Method of treating hangover
WO2001049822A2 (fr) * 1999-12-29 2001-07-12 Sergei Mikhailovich Zenovich Agents physiologiquement actifs contenant dithioglyols et leur application dans differentes secteurs
US6245815B1 (en) * 2000-04-15 2001-06-12 Bionumerik Pharmaceuticals, Inc. Method of treating alcoholism and complications resulting therefrom
US6291441B1 (en) * 2000-09-27 2001-09-18 Frederick H. Hausheer Method of treating inflammatory bowel disorders
US6352979B1 (en) * 2001-08-20 2002-03-05 Lucinda Lizcano Method of treating snakebite and complications resulting therefrom
US20050272698A1 (en) * 2002-09-05 2005-12-08 Daftary Gautam V Liquid stable composition of oxazaphosphorine with mesna
US7025998B2 (en) 2003-05-30 2006-04-11 Rotta Research Laboratorium S.P.A. Phytoestrogens and probiotic for women's health
ES2369776T3 (es) * 2003-10-01 2011-12-05 Baxter International Inc. Nueva utilización, preparados farmacéuticos y procedimiento para su producción.
MXPA06006709A (es) * 2003-12-17 2006-08-31 Bionumerik Pharmaceuticals Inc Proceso para sintetizar disulfuros.
US20060063742A1 (en) * 2004-09-21 2006-03-23 Hausheer Frederick H Method of treatment for or protection against lymphedema

Citations (1)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
DE1620629A1 (de) * 1965-05-07 1969-10-16 Ucb Sa Verbindungen mit mucolytischer Aktivitaet und sie enthaltende Mittel und Verfahren zu ihrer Herstellung

Patent Citations (1)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
DE1620629A1 (de) * 1965-05-07 1969-10-16 Ucb Sa Verbindungen mit mucolytischer Aktivitaet und sie enthaltende Mittel und Verfahren zu ihrer Herstellung

Cited By (4)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US4716242A (en) * 1984-03-01 1987-12-29 Asta-Werke Aktiengesellschaft Chemische Fabrik Salts of oxazaphosphorine derivatives
EP0198542A1 (fr) * 1985-04-15 1986-10-22 Schering Spa Compositions pharmaceutiques à base d'acide mercaptoéthanesulfonique, dérivés salins organiques d'acide mercaptoéthanesulfonique et leur procédé de fabrication
EP0334083A1 (fr) * 1988-03-19 1989-09-27 ASTA Pharma Aktiengesellschaft Composition lyophilisée à base de ifosfamide-mesna et procédé pour sa préparation
US5663145A (en) * 1993-12-09 1997-09-02 Asta Medica Aktiengesellschaft Products for administering an initial high dose of Cetrorelix and producing a combination package for use when treating diseases

Also Published As

Publication number Publication date
DK553978A (da) 1979-06-15
DK154608C (da) 1989-05-08
JPS54101432A (en) 1979-08-10
DK154608B (da) 1988-12-05
JPS6154006B2 (fr) 1986-11-20
FI783756A (fi) 1979-06-15
EP0002495B1 (fr) 1984-02-15
NO784192L (no) 1979-06-15
US4220660A (en) 1980-09-02

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